Can virtual reality therapy help you get over your fear of cockroaches and other phobias? We tried it out
Can virtual reality therapy help you get over your fear of cockroaches and other phobias? We tried it out
We put our CNA Lifestyle senior producer, who always keeps Baygon and cockroach baits in every corner of her apartment and bedroom, through a session to find out.
Would you put yourself through an episode of Fear Factor, especially one that is designed to tap into your deepest, most terrifying fear – your very own personal nightmare, so to speak? CNA Lifestyle's intrepid senior producer Joyee Koo did and came face-to-face with her mortal fear: Cockroaches, especially flying ones.
“I would leap out of my seat at the sight of a cockroach and grab the nearest can of Baygon,” said Koo, echoing a reaction many Singaporeans share. She keeps a can, along with cockroach baits, in every corner of her apartment and bedroom.
"My heart would be racing as I empty almost half a can on the cockroach. My whole house would smell like Baygon for two days. And even with half a can, the cockroach is still moving! I would be trembling even after it stops.”
Unfortunately, Koo encounters these harrowing incidents once a month on average. “My apartment is not dirty. I think it’s because they don’t maintain the condominium environment well. I live on the 20th floor, right beside a forested area and the cockroaches are huge! When they get into my house, they always run towards me. They will do anything to come as near to me as they can.
“I am so fearful of them that I don’t open any of my windows anymore. You know the small window in the bathroom for ventilation? I even close that. It’s affecting my lifestyle,” she said.
GETTING TO THE ROOT
At Olive Branch Psychology & Therapy Clinic, where virtual reality (VR) therapy may be used to treat phobias, a soft-spoken Sam Roberts began the session with a chat to understand Koo’s fear of cockroaches and where it’s coming from.
Other than gleaning information about her background and history, and assessing the severity of her phobia, the conversation served another purpose, said Roberts: To help her rationalise her emotions and shift her thinking from “cockroaches are out to get me” to “cockroaches are just surviving and looking for food”.
Sometimes, it may not be cockroaches at all. “We may move into something else. Generally, I’ll be helping her to become more aware of how she is reacting to fear, anger, sadness and how to manage these other emotions.”
The counsellor and centre director has been using VR therapy as an adjunct treatment for phobia for three years, and each session can last about 20 to 30 minutes, depending on how fearful the individual becomes.
“Through repeated exposure and guided therapeutic interventions, the skills learned in the virtual environment can generalise to real-life situations, where individuals report feeling more confident and better equipped to face their fear of cockroaches outside of the therapy setting,” he said.
And it’s not always about insects either, according to Roberts; neither does VR therapy take place in the first session, especially when the client is not ready. “We have to understand the psychodynamics, like what’s happening,” he said. “Some have a fear of heights, crowds, getting into a taxi. They may have a lot of trauma and emotional abuse.”
Roberts customises the VR environment to suit the client’s specific needs and phobia severity. For instance, the virtual environment could be a stage to help those with stage fright overcome their fear of public speaking. “We can also take a socially anxious person to a virtual restaurant or bar, and let them talk to a character,” he said.
For Koo, her fear stemmed from childhood and grew “because I’m living alone now when previously, I had my parents to deal with the cockroaches. Now, I have to kill them myself and managing it alone increased my fear”.
It doesn’t help that Koo often hears horror stories of juvenile cockroaches crawling into human orifices, such as the ears. “I don’t want them around me just in case that happens to me,” she said. “Those that can fly, they are unpredictable. I just find them very pointless.”
LET THE (VR) THERAPY BEGIN
What Koo saw when she strapped on the VR headset was a glass case of cockroaches placed at the end of a table. “If you’re ready, I’ll put the ‘cockroaches’ on the table,” said Roberts. “If you agree, I will let them touch you. Depending on how prepared you are, we will slowly increase the exposure.”
There was a short pause. Koo rubbed her arms and nodded. “I feel like because this is not real, I’m going to be fine.”
With Roberts controlling the VR programme via a laptop, the virtual cockroaches started to stir and climb out of the case. “Oh-kay, these look like baby ones. They definitely don’t look like the ones in my house,” Koo said, sounding slightly relieved.
“They’re coming towards me now,” she said, still composed and calmly narrating what she was seeing on the headset. She held out her right arm. “These are bigger and they’re about an arm’s length from me. I think they’re trying to get onto me…”
A little while later, Koo let out a short “eeek!”. “One just got onto my arm.” There was another pause, then she added: “But I know it’s not out to attack me. It’s just trying to get to the 'biscuits' next to me”.
Despite placing more “cockroaches” near her, even one right in front of her, Koo didn’t tremble or display signs of panic – until she suddenly clutched her face in her hands and let out a loud shriek. “Oh my gosh, one just flew up right in front of me!”
HOW DOES VR THERAPY WORK?
Just how effective can VR therapy be when you are aware that there aren’t any real cockroaches in the same room as you? “For those who are really immersed in the virtual reality, they freak out,” said Roberts, adding that clients with varying severity of symptoms may require eight to 12 weekly sessions for specific phobias.
He was surprised that Koo kept her composure for the most part of the session. “It's quite common for individuals with specific phobias to experience heightened anxiety or discomfort,” he said. And while he hasn’t had clients run out of the room screaming, there could be increased heart rate, sweating, trembling or even nausea.
“It’s good that you were reminding yourself and remembering what I told you, that the cockroaches are not going to attack, they’re just looking for food,” he said to her. “So, all those thoughts have calmed you down. It is an exercise where you’ll see a bit of change the next time you see a cockroach.”
Would the therapy’s effect be different if real cockroaches were used instead? “The limitation with real cockroaches is we can’t control where they move, how much they move,” said Roberts. “The programme lets me control the cockroaches’ number, size, distance to the client, direction they’re heading, touching the client’s hand. I am trying to be in her shoes.”
And sometimes, “direct exposure to the situation is not practical”, he continued. “The client may have already let their emotions take over. Here, we can talk and process the thoughts. I can already see some shifts that Joyee has already taken for herself. Her belief system has shifted a little to know that okay, the cockroaches are not going to harm her.”
CAN THE FEAR RETURN AFTER THERAPY?
“Yes, the relapse of any phobia can occur,” said Roberts. Traumatic experiences, life stressors, changes in the environment, encountering the fear in a different context are some of the factors that can trigger and reactivate the phobia, he said.
“Understanding potential triggers, and having strategies and adequate skills to continuously practise and apply them in new situations are an important aspect of managing and preventing a relapse,” said Roberts. When the fear returns, exposure therapy can be used again and coping strategies can be practised to help the individual regain a sense of control and reduce anxiety, he said.
THE OUTCOME
Koo said that it helped when the virtual cockroaches were gradually moved towards her, giving her time to process her emotions. But the biggest takeaway was that she had “never thought so deeply about cockroaches”. Speaking to a professional had a different outcome for her compared to say, talking to friends about her phobia. "If I were having this conversation with friends, it would be back-to-back horror stories," she said.
Roberts agreed. "I don’t think there would be so much reflection. Everyone is going to say cockroaches are bad and share their negative experiences. From such conversations, you wouldn’t get a different perspective. You may feel your emotions are being dismissed when they say things like, aiyah, why are you feeling like that."
Are cockroaches still Koo's mortal enemies? "Not that I embrace cockroaches now but I would look at them differently and be able to be in more control when I next see them.”
If you're thinking of giving VR therapy a shot, the key is to not overthink it. “Just go with the flow and whatever comes, comes," said Koo. For now, "it’s something I would practise the next time I see cockroaches, which is probably next month!", she quipped.